858 Ivy Lane - Inspection Forms4
Eity of Ea u
Residential Sanitary Sewer Service
Compliance Inspection
Date/ I ' J_' i Time , r_ i • O pm
Name . t ° s a r " lgl lj'f 1 Disk #
PID Number
House Number
Alternative Mailing Address Phone (')- ? 1 7‘77
/
Street Name
nerIOccupant Signature
Record Number
Time
O arji
•
• o pm
Inspector Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Property Owner
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanita
sewer
O Flexible sump pump piping
y
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S ,L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection,
Damaged Pipe
Transition
Length of Service: Final Cleanout:
Notes
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
` 1
•
Yellow Copy: City of Eagan Pink Copy: SEH
Total
Number Discharged
Correctly
Incorrectly Unknown
Sump pumps
Foundation drains
Roof drains
4
Eity of Ea u
Residential Sanitary Sewer Service
Compliance Inspection
Date/ I ' J_' i Time , r_ i • O pm
Name . t ° s a r " lgl lj'f 1 Disk #
PID Number
House Number
Alternative Mailing Address Phone (')- ? 1 7‘77
/
Street Name
nerIOccupant Signature
Record Number
Time
O arji
•
• o pm
Inspector Signature
For information call 651.470.2788
Compliance
O No foundation drain connection
O No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
O No sump pump
4" to 6" Transition:
White Copy: Property Owner
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanita
sewer
O Flexible sump pump piping
y
Obstruction
Unable to push past
feet
Service Lateral Inspection Findings Number of stacks Entered S ,L. at
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection,
Damaged Pipe
Transition
Length of Service: Final Cleanout:
Notes
No Access
O No one in
Access to service
lateral needed
O Inspection
refused
` 1
•
Yellow Copy: City of Eagan Pink Copy: SEH
City of to
Residential Sanitary Sewer Service
Compliance Inspection
Date / I (- /
Name
PID Number
Street Name
House Number
Alternative Mailing Address
r `%
4" to 6 "Transition:
Compliance
O No foundation drain connection
/ci No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Property Owner
Time
;;owner /Occupant Signature
Disk #
ii
o am
pm
Length of Service:
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Yellow Copy: City of Fagan
.!� •
Time •
r
Record Number
Phone )
Number of stacks I i Entered S.L. atoms'
:
/1
Lid o am
pm
inspector Signature
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Service Lateral inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
, 1
1 9f %
t:
l Cleanout: 7 ;;
is a ._. .
Pink Copy: SEH
Number
Correctly
Discharged
Incorrectly Unknown
Notes }
','�'� ? c t j`" -,,.I-7- g
- _.. , ;. -
1 2,
i .
} J l -�
.
1
�'r \ ti�� r� w i' f � '`
Total
Sump pumps
/
im
X
Foundation drains
Roof drains
I
1, !' < a` , / .. .J -"'' , .i.. .--y �`"
City of to
Residential Sanitary Sewer Service
Compliance Inspection
Date / I (- /
Name
PID Number
Street Name
House Number
Alternative Mailing Address
r `%
4" to 6 "Transition:
Compliance
O No foundation drain connection
/ci No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Property Owner
Time
;;owner /Occupant Signature
Disk #
ii
o am
pm
Length of Service:
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Yellow Copy: City of Fagan
.!� •
Time •
r
Record Number
Phone )
Number of stacks I i Entered S.L. atoms'
:
/1
Lid o am
pm
inspector Signature
For information call 651.470.2788
Obstruction No Access
Unable to push past 0 No one in
feet
O Access to service
lateral needed
O Inspection
refused
Service Lateral inspection Findings
Roots
Poor Pipe Joints
Mineral Deposits
Sag /Pipe Deflection
Damaged Pipe
Transition
, 1
1 9f %
t:
l Cleanout: 7 ;;
is a ._. .
Pink Copy: SEH